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October 1955

Treatment of Portal Hypertension with Hepatic Artery Ligation: An Evaluation

Author Affiliations

Cincinnati; Covington, Ky.; Cincinnati
From the Department of Surgery of the University of Cincinnati College of Medicine and the Cincinnati General Hospital

AMA Arch Surg. 1955;71(4):571-580. doi:10.1001/archsurg.1955.01270160097012

Of the numerous surgical procedures which have been developed for the treatment of cirrhotic patients with portal hypertension complicated by esophageal varices and gastrointestinal hemorrhage, ligation of the hepatic and splenic arteries with or without ligation of the left gastric artery has received considerable attention during the past four years.

Opinions among surgeons have differed greatly as to whether or not the procedure of arterial ligation offers any lasting benefit to cirrhotic patients. The original reports of Rienhoff1 and Berman2 indicated that favorable results followed the procedure. In Rienhoff's series, 50% of the cases surviving hepatic and splenic arterial ligation for hemorrhage were benefited, and 11 of 13 who underwent ligation for intractable ascites were improved.

On the other hand, Madden3 and McFadzean and Cook4 have concluded that the operation was useless. Only one of Madden's eight cases survived hepatic artery ligation, and he therefore felt

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